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Acta Neurochirurgica

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01.05.2014 | Clinical Article - Vascular

Indocyanine green videoangiography for assessment of postoperative hyperperfusion in moyamoya disease

verfasst von: Nobutaka Horie, Yuhtaka Fukuda, Tsuyoshi Izumo, Kentaro Hayashi, Kazuhiko Suyama, Izumi Nagata

Erschienen in: Acta Neurochirurgica | Ausgabe 5/2014

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Abstract

Background

Postoperative cerebral hyperperfusion (HP) is a notable complication that occurs more frequently in moyamoya disease (MMD) than in atherosclerosis. This study aimed to clarify the characteristics of intraoperative indocyanine green (ICG) videoangiography in MMD and atherosclerotic disease in terms of postoperative HP.

Methods

This prospective study included 47 patients with 60 sides that underwent superior temporal artery (STA)-middle cerebral artery (MCA) single bypass. ICG videoangiography was performed after revascularization. The ICG time intensity curve was recorded in the STA, proximal MCA, distal MCA, and superficial Sylvian vein, and the angiographic differences among adult MMD, pediatric MMD, and atherosclerosis were analyzed.

Results

Twenty-two patients (27 sides) had adult MMD, 14 patients (22 sides) had pediatric MMD, and 11 patients (11 sides) had atherosclerosis. Postoperative HP was significantly higher in adult MMD (40.7 %) than in pediatric MMD (18.2 %) and atherosclerosis (0 %). Adult MMD with HP was associated with a longer ICG peak time (P < 0.001). There was no correlation between the ICG peak time and preoperative cerebral blood flow or vascular reserve. The ratio of the vessel caliber was also higher in adult MMD with HP (P < 0.001).

Conclusions

ICG videoangiography provides different characteristics of bypass flow among adult MMD, pediatric MMD, and atherosclerosis. Poor run-off and stagnation of blood flow from the STA might contribute to postoperative HP in MMD. The occurrence of postoperative HP in MMD could depend on two factors: donor STA size and poor run-off and integrity of the blood brain barrier in the recipient MCA.

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Titel: Indocyanine green videoangiography for assessment of postoperative hyperperfusion in moyamoya disease
verfasst von: Nobutaka Horie
Yuhtaka Fukuda
Tsuyoshi Izumo
Kentaro Hayashi
Kazuhiko Suyama
Izumi Nagata
Publikationsdatum: 01.05.2014
Verlag: Springer Vienna
Erschienen in: Acta Neurochirurgica / Ausgabe 5/2014
Print ISSN: 0001-6268
Elektronische ISSN: 0942-0940
DOI: https://doi.org/10.1007/s00701-014-2054-4

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Abstract

Background

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Conclusions

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